What is the difference between torsemide and furosemide

Torsemide vs. Author s : Margaret Tsien, MD. Margaret Tsien. Quality Geographic cohorting increased direct care time and interruptions Publish date: October 20, Practice Management What does it mean to be a trustworthy male ally? Publish date: November 10, From the Society Mean leadership Publish date: September 23, Matt Aldrich Publish date: March 30, Menu Close. Moreover, a higher percentage of patients in the optimized furosemide arm than the torsemide arm were on ACE inhibitors Since torsemide is a more potent loop diuretic with higher bioavailability and less erratic absorption in patients with HF that retains its pharmacodynamic effects regardless of the HF severity compared to furosemide [ 4 , 5 , 10 ], it was hypothesized that changing furosemide to torsemide would result in more favorable clinical outcomes than increasing the dose of furosemide following ADHF among patients already using furosemide prior to admission.

Nevertheless, the study neither evaluated changing furosemide to torsemide nor conducted an analysis of the patients already using a loop diuretic prior to admission [ 12 ]. However, our study answered a crucial clinical question of whether switching furosemide to a more potent diuretic torsemide following ADHF without increasing the dose would reduce HF-related hospitalization compared to increasing the furosemide dose.

In our study, patients in the furosemide arm were discharged on double the baseline dose, while patients in torsemide arm were switched to torsemide at doses equivalent to the baseline furosemide dose and there was no difference between the two approaches in terms of clinical outcomes.

Therefore, switching furosemide to an equivalent dose of torsemide may be as effective as optimizing the dose of furosemide after ADHF, which may represent a therapeutic advantage for torsemide. In the present study, we investigated the predictors of torsemide use.

Although these associations do not necessarily indicate causality, they might reflect a trend in prescribing pattern or highlight some indicators of disease progression to a stage where furosemide does not achieve the desired level of euvolemia.

Interestingly, similar to Mentz et al. This was a retrospective observational study which is susceptible to potential limitations. First, data were collected from the medical records with the expectation of missing some essential clinical information. Second, the study did not evaluate the impact on mortality of switching torsemide to furosemide versus optimizing the furosemide dose. However, we did not expect a difference in mortality due to lack of difference in placebo-controlled studies of furosemide.

Third, the results were adjusted for clinically significant variables; however, there is a potential for other measured or unmeasured variables to influence the results.

Forth, the number of torsemide users and optimized furosemide users were relatively small, which might have affected the robustness of the results. Nevertheless, this retrospective observational study aimed to answer a clinically important and challenging question that is faced by clinicians in daily practice, and it could serve as a preliminary indicator for future prospective studies to assess the impact of torsemide versus furosemide following ADHF on cardiovascular outcomes.

In conclusion, switching furosemide to an equivalent dose of torsemide after ADHF was not associated with reduced HF-related hospitalization compared to optimizing the furosemide dose. Therefore, following ADHF, clinicians can follow either approach.

However, larger prospective clinical trials are needed to confirm the findings of this study and to assess other important cardiovascular outcomes, including mortality. The datasets generated during this study are available from Hamad Medical Corporation electronic database, but restrictions apply to the availability of the data according to legal regulations of Qatar. Heart disease and stroke statistics update: a report from the American Heart Association.

Article PubMed Google Scholar. Eur Heart J. Article Google Scholar. Diuretics and ultrafiltration in acute decompensated heart failure. J Am Coll Cardiol. Heart Failure Society of America. Executive summary: HFSA comprehensive heart failure practice guideline. J Card Fail. Beneficial effects of Torasemide on Systolic Wall stress and sympathetic nervous activity in asymptomatic or mildly symptomatic patients with heart failure: comparison with Azosemide.

J Cardiovasc Pharmacol. Open-label randomized trial of torsemide compared with furosemide therapy for patients with heart failure. Am J Med ; 7 — Accessed 20 May Eur J Heart Fail. Inotropic agents use in patients hospitalized with acute decompensated heart failure: a retrospective analysis from a year registry in a middle-eastern country BMC Cardiovasc Disord.

Pharmacokinetics of torsemide in patients with decompensated and compensated congestive heart failure. J Clin Pharmacol ;38 8 — DiNicolantonio JJ.

Should torsemide be the loop diuretic of choice in systolic heart failure? Futur Cardiol. Download references. The funders had no role in the design, planning and implementation of the project, or the preparation of this manuscript. It can also happen with oral torsemide therapy. For this reason, continuous intravenous infusion is preferred over rapid injection, and monitoring should be done in patients with renal insufficiency.

When using Lasix in the adjunct treatment of ascites, therapy is best initiated in a hospital setting. Sudden fluid depletion and electrolyte imbalance may precipitate a hepatic coma in patients with liver disease or cirrhosis. The use of Lasix in ascites is only intended to be in addition to aldosterone antagonists. Patients on any diuretics, including loop diuretics, are at risk for fluid depletion and electrolyte imbalance.

Patients on torsemide and Lasix should be monitored for signs and symptoms such as dry mouth, thirst, weakness, lethargy, muscle pain and cramps, hypotension, and tachycardia increased heart rate. With loop diuretics, hypokalemia, or low potassium, is one of the most common electrolyte imbalances. Increased levels of blood urea nitrogen BUN may also occur.

Your physician may do periodic bloodwork to monitor your electrolyte levels. Torsemide is a prescription medication used in the management of edema and hypertension.

It is a loop diuretic and works by removing excess fluid from the interstitial space of tissues. Torsemide is available in oral tablets in strengths of 5 mg, 10 mg, and 20 mg. Lasix is a prescription medication used in the management of edema and hypertension. It is also a loop diuretic. Lasix is available in oral tablets in strengths of 20 mg, 40 mg, and 80 mg. Torsemide and Lasix are both loop diuretics but are not exactly the same.

Torsemide is twice as potent as Lasix. Lasix carries a broader range of indications for use. Torsemide is associated with lower rates of hospitalizations for CHF as compared to Lasix. It is also associated with a higher level of clinical improvement in CHF patients and lower rates of mortality related to cardiovascular disease when compared directly to Lasix.

Torsemide is pregnancy category B, meaning no animal studies have shown fetal harm and there have been no studies in pregnant women. It should not be used unless absolutely necessary. Lasix is pregnancy category C, meaning there have been no well-controlled clinical trials to establish safety.

Lasix should only be used when the benefits clearly outweigh the risks. Alcohol consumption may lead to dehydration and electrolyte imbalance. Torsemide and Lasix, when taken with alcohol, may significantly increase the risk of severe dehydration and electrolyte imbalance. A recent meta-analysis comparing torsemide versus furosemide shows that torsemide may be associated with better clinical outcomes in heart failure patients as compared to furosemide, including lower hospitalization rates, improved functional status, and decreased cardiac morbidity.

Torsemide also has a longer half-life and works for longer periods of time in the body. Torsemide should be used very cautiously in patients with renal disease.

Hypovolemia, or low fluid volume, caused by diuretic, can be especially dangerous in patients with pre-existing kidney disease. Torsemide is twice as potent as Lasix in a milligram per milligram comparison and has been associated with improved clinical outcomes as compared to Lasix. Torsemide is a substitute for Lasix when clinical outcomes are not being reached with Lasix.

They are both loop diuretics used in edema management and the treatment of hypertension, but torsemide has been shown to be more potent. Skip to main content Search for a topic or drug. Torsemide vs. Lasix: Differences, similarities, and which is better for you. By Gerardo Sison, Pharm. Top Reads in Drug vs.